Acute Cardiac Injury and COVID-19 – A Systematic Review and Meta-analysis

Abstract

Introduction:The ongoing global pandemic, coronavirus disease 2019 (COVID-19), an illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has ranged from an asymptomatic state to unprecedented number of deaths worldwide. In symptomatic patients, a viral pneumonia can unrelentingly progress to multi-system failure with preferential cardiac tropism. Although the full spectrum of COVID-19 cardiac manifestations is still not clear; acute cardiac injury (ACI) remains a common finding. The goal of our study, not only is to examine the current prevalence of ACI among COVID-19 infected patients but also, the reported mortality.Method:After thoroughly searching the literature for appropriate studies, a systematic review and meta-analysis were performed. Inclusion criteria were 1) Cohort study, case-control study, or case series study. 2) The study population included individuals with COVID-19 3) The presence or absence of cardiac injury was reported in the study 4) Mortality among patients with cardiac injury is reported or can be calculated.Results:Ten studies were included with a total of 1664 patients. The prevalence of ACI was 30.8%. The mortality rate among patients with concurrent COVID-19 and ACI was 53%.Conclusion:ACI can occur in one third of patients with COVID-19. Concurrent COVID-19 and ACI entails a high mortality rate. Serum troponin level can be a good prognostic tool in COVID-19.

Early Diagnosis and Clinical Significance of Acute Cardiac Injury - Under the Iceberg: A Retrospective Cohort Study of 619 Non-critically Ill Hospitalized COVID-19 Pneumonia Patients

“…A recent meta-review revealed that the OR of patients with ACI and finally died was 3.41. The risk rate varies from 1.30 to 11.40 based on several researches 22 and our study shows the number of ACRI patients who died was 42 times that of those without ACRI ( Table 1 ).…”

“…Also, the top three manifestations of severe COVID-19 disease include ARDS, hyper-inflammation and acute cardiac injury, arrhythmias, cardiomyopathy, which suggests that cardiovascular system injury may play an important role in COVID-19 severe patients 21 . Furthermore, a meta-analysis including 1664 patients illustrated that ACI could occur in one third of patients with COVID-19 22 . More than one studies have demonstrated that Cardiac injury was independently associated with significantly increase of mortality 22, 23 .…”

“…Furthermore, a meta-analysis including 1664 patients illustrated that ACI could occur in one third of patients with COVID-19 22 . More than one studies have demonstrated that Cardiac injury was independently associated with significantly increase of mortality 22, 23 . Considering the above conclusion, we believe early diagnosis and treatment will be much important to improve the prognosis of ACI patients with COVID-19.…”

COVID-19-Induced Cardiac Tamponade: A Case Study and a Literature Review

“…It is crucial to identify and treat the underlying infectious cause to manage pericardial effusion effectively. COVID-19 can have variable presentations; however, prior to the era of COVID-19 vaccinations, there was not enough data establishing the presence of pericardial effusion with tamponade and its therapy [1][2][3][4][5]. This is the case of a patient who was found to have cardiac tamponade induced by the first wave of COVID-19.…”